Outline

Objective: Spontaneous intracerebral hemorrhage (ICH) frequently presents a fatal course. Up to now no treatment has doubtlessly showed a relevant improvement of the outcome. Statins are cholesterol reducers with pleiotropic effects that results in neuroprotection. We conducted a study in order to evaluate if the continued treatment with statins after ICH is associated with a better outcome

Methods: From January 2008 to December 2009 we accomplished a cohort of 201 patients with ICH admitted in our department for acute treatment. In 25 patients using statins before the ICH, the statin was continuously administered for the first 24 hours after ICH. Patients with head injury within four weeks prior to admission, with a cerebral tumor, with hemorrhage after ischemic stroke and NIHSS (National Institute Health Stroke Scale) >30 points at admission were excluded. Control-patients were assigned in a ratio 1:4. Mortality in hospital and NIHSS at discharge were assessed as outcome variables.

Results: Clinical characteristics were similar in both groups at admission. No mortality was observed in patients with continued statin therapy while 15 patients (15.1%) without statin died (p=0.04). The patients with statin-therapy showed lower NIHSS at discharge than controls (mean 13 versus 18, p=0.02).

Conclusions: The continued use of statins after an ICH seems to be associated with a better outcome in the acute phase. Randomized, prospective clinical trials are necessary in order to explore a possible therapeutic effect in the acute management of ICH.